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Preview: Neuropsychology - Vol 24, Iss 1

Neuropsychology - Vol 31, Iss 2

Neuropsychology focuses on (a) basic research, (b) the integration of basic and applied research, and (c) improved practice in the field of neuropsychology. The primary function of Neuropsychology is to publish original, empirical research on the relation

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Copyright: Copyright 2017 American Psychological Association

Suboptimal decision making by children with ADHD in the face of risk: Poor risk adjustment and delay aversion rather than general proneness to taking risks.


Objective: Suboptimal decision making in the face of risk (DMR) in children with attention-deficit hyperactivity disorder (ADHD) may be mediated by deficits in a number of different neuropsychological processes. We investigated DMR in children with ADHD using the Cambridge Gambling Task (CGT) to distinguish difficulties in adjusting to changing probabilities of choice outcomes (so-called risk adjustment) from general risk proneness, and to distinguish these 2 processes from delay aversion (the tendency to choose the least delayed option) and impairments in the ability to reflect on choice options. Based on previous research, we predicted that suboptimal performance on this task in children with ADHD would be primarily relate to problems with risk adjustment and delay aversion rather than general risk proneness. Method: Drug naïve children with ADHD (n = 36), 8 to 12 years, and an age-matched group of typically developing children (n = 34) performed the CGT. Results: As predicted, children with ADHD were not more prone to making risky choices (i.e., risk proneness). However, they had difficulty adjusting to changing risk levels and were more delay aversive—with these 2 effects being correlated. Conclusions: Our findings add to the growing body of evidence that children with ADHD do not favor risk taking per se when performing gambling tasks, but rather may lack the cognitive skills or motivational style to appraise changing patterns of risk effectively. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

The impact of family factors on IQ in pediatric medically refractory epilepsy.


Objective: To evaluate whether family factors were associated with intellectual functioning among children with medically refractory epilepsy, and whether family factors moderate the relationship between patient/epilepsy-related variables and intellectual functioning. Method: Children aged 4 to 18 years with medically refractory epilepsy who were evaluated for surgical candidacy were recruited. The authors assessed the association of intellectual quotient (IQ) with patient, epilepsy, and family factors. Family factors included parental education, household income, and validated parent-report measures of family functioning, family mastery and social support, and family demands. Results: Univariable analyses showed that higher IQ scores were associated with an older age of epilepsy onset (β = .260, p = .009), fewer antiepileptic drugs (β = .248, p = .013), a shorter duration (β = .384, p < .001) and percentage of life with epilepsy (β = .419, p < .001), unilobar epileptogenic foci relative to multilobar foci (β = .274, p = .006), and lower family demands (β = .211, p = .035). In multivariable analysis, unilobar epileptogenic foci (p = .010) and a shorter percentage of life with epilepsy (p = .001) remained significant predictors of IQ. Exploratory moderation analyses found the relationship between the extent of epileptogenic foci and IQ to be moderated by family demands (p = .004); specifically, patients with unilobar epileptogenic onset had similar IQ scores irrespective of family demands, whereas patients with multilobar foci had lower IQ scores with increasing family demands. Conclusion: Family factors did not have a large impact on IQ among children with medically refractory epilepsy, although the moderating effect of family demands deserves further study. Epilepsy-related factors in this patient group may weaken the link between child IQ and family factors. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Pediatric traumatic brain injury affects multisensory integration.


Objective: To investigate the impact of pediatric traumatic brain injury (TBI) on multisensory integration in relation to general neurocognitive functioning. Method: Children with a hospital admission for TBI aged between 6 and 13 years (n = 94) were compared with children with trauma control (TC) injuries (n = 39), while differentiating between mild TBI without risk factors for complicated TBI (mildRF−; n = 19), mild TBI with ≥1 risk factor (mildRF+; n = 45), and moderate/severe TBI (n = 30). We measured set-shifting performance based on visual information (visual shift condition) and set-shifting performance based on audiovisual information, requiring multisensory integration (audiovisual shift condition). Effects of TBI on set-shifting performance were traced back to task strategy (i.e., boundary separation), processing efficiency (i.e., drift rate), or extradecisional processes (i.e., nondecision time) using diffusion model analysis. General neurocognitive functioning was measured using estimated full-scale IQ (FSIQ). Results: The TBI group showed selectively reduced performance in the audiovisual shift condition (p = .009, Cohen’s d = −0.51). Follow-up analyses in the audiovisual shift condition revealed reduced performance in the mildRF+ TBI group and moderate/severe TBI group (ps ≤ .025, ds ≤ −0.61). These effects were traced back to lower drift rate (ps ≤ .048, ds ≤ −0.44), reflecting reduced multisensory integration efficiency. Notably, accuracy and drift rate in the audiovisual shift condition partially mediated the relation between TBI and FSIQ. Conclusion: Children with mildRF+ or moderate/severe TBI are at risk for reduced multisensory integration efficiency, possibly contributing to decreased general neurocognitive functioning. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

First-order and higher order sequence learning in specific language impairment.


Objective: A core claim of the procedural deficit hypothesis of specific language impairment (SLI) is that the disorder is associated with poor implicit sequence learning. This study investigated whether implicit sequence learning problems in SLI are present for first-order conditional (FOC) and higher order conditional (HOC) sequences. Method: Twenty-five children with SLI and 27 age-matched, nonlanguage-impaired children completed 2 serial reaction time tasks. On 1 version, the sequence to be implicitly learnt comprised a FOC sequence and on the other a HOC sequence. Results: Results showed that the SLI group learned the HOC sequence (ηp² = .285, p = .005) but not the FOC sequence (ηp² = .099, p = .118). The control group learned both sequences (FOC ηp² = .497, HOC ηp2= .465, ps < .001). Conclusions: The SLI group’s difficulty learning the FOC sequence is consistent with the procedural deficit hypothesis. However, the study provides new evidence that multiple mechanisms may underpin the learning of FOC and HOC sequences. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Neuropsychological functioning in college students with and without ADHD.


Objective: Increasing numbers of students with attention-deficit/hyperactivity disorder (ADHD) are attending college; however, little empirical information is available concerning the functional impairment experienced by these students. Although preliminary studies suggest that college students with ADHD are more likely to experience a variety of psychosocial and academic difficulties compared to their peers without the disorder, findings regarding neuropsychological functioning have been inconsistent with some studies reporting that college students with ADHD perform more poorly on various cognitive and neuropsychological tasks while others report no differences compared to their peers without ADHD. Method: The purposes of the present study, the Trajectories Related to ADHD in College project, a longitudinal study following the 4-year outcomes of college students with and without ADHD, were to (a) examine the performance of 436 first-year college students with and without ADHD (51.6% female) on measures of executive function (EF) and intelligence and (b) investigate the association of self-reported use of stimulant medication and neuropsychological performance in students with ADHD. Participant data from their first year of involvement in the study were analyzed. Results: Participants with ADHD performed more poorly on task-based and self-report EF measures relative to the comparison group. In contrast, no significant group differences were found with respect to intellectual performance. Within the ADHD group, use of prescription stimulant medication was associated with improved performance on some, but not all, neuropsychological tasks. Additional analyses also revealed significant group differences in EF based on clinical diagnostic status. Conclusion: College students with ADHD demonstrated poorer EF than their peers without ADHD and psychostimulant medication was associated with improved EF performance. No group differences were found with respect to intellectual functioning, Lastly, having one or more comorbid psychiatric diagnoses in addition to ADHD was associated with poorer EF outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Understanding perceptual judgment in autism spectrum disorder using the drift diffusion model.


Objective: Two-alternative forced-choice tasks are widely used to gain insight into specific areas of enhancement or impairment in individuals with autism spectrum disorder (ASD). Data arising from these tasks have been used to support myriad theories regarding the integrity, or otherwise, of particular brain areas or cognitive processes in ASD. The drift diffusion model (DDM) provides an account of the underlying processes which give rise to accuracy and reaction time (RT) distributions, and parameterizes these processes in terms which have direct psychological interpretation. Importantly, the DDM provides further insight into the origin of potential group differences in task performance. Here, for the first time, we used the DDM to investigate perceptual decision making in ASD. Method: Adults with (N = 25) and without ASD (N = 32) performed an orientation discrimination task. A drift diffusion model was applied to the full RT distributions. Results: Participants with ASD responded more slowly than controls, the groups did not differ in accuracy. Modeled parameters indicated that: (a) participants with ASD were more cautious than controls (wider boundary separation); (b) nondecision time was increased in ASD; and (c) the quality of evidence extracted from the stimulus (drift rate) did not vary between groups. Conclusions: Taking the behavioral data in isolation would suggest reduced perceptual sensitivity in ASD. However, DDM results indicated that despite response slowing, there was no evidence of differential perceptual sensitivity between participants with and without ASD. Future use of the DDM in investigations of perception and cognition in ASD is highly recommended. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Visual perceptual load reduces auditory detection in typically developing individuals but not in individuals with autism spectrum disorders.


Objective: Previous studies examining selective attention in individuals with autism spectrum disorder (ASD) have yielded conflicting results, some suggesting superior focused attention (e.g., on visual search tasks), others demonstrating greater distractibility. This pattern could be accounted for by the proposal (derived by applying the Load theory of attention, e.g., Lavie, 2005) that ASD is characterized by an increased perceptual capacity (Remington, Swettenham, Campbell, & Coleman, 2009). Recent studies in the visual domain support this proposal. Here we hypothesize that ASD involves an enhanced perceptual capacity that also operates across sensory modalities, and test this prediction, for the first time using a signal detection paradigm. Method: Seventeen neurotypical (NT) and 15 ASD adolescents performed a visual search task under varying levels of visual perceptual load while simultaneously detecting presence/absence of an auditory tone embedded in noise. Results: Detection sensitivity (d′) for the auditory stimulus was similarly high for both groups in the low visual perceptual load condition (e.g., 2 items: p = .391, d = 0.31, 95% confidence interval [CI] [−0.39, 1.00]). However, at a higher level of visual load, auditory d′ reduced for the NT group but not the ASD group, leading to a group difference (p = .002, d = 1.2, 95% CI [0.44, 1.96]). As predicted, when visual perceptual load was highest, both groups then showed a similarly low auditory d′ (p = .9, d = 0.05, 95% CI [−0.65, 0.74]). Conclusions: These findings demonstrate that increased perceptual capacity in ASD operates across modalities. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Effects of drinking patterns on prospective memory performance in college students.


Objective: Traditional college students are at a critical juncture in the development of prospective memory (PM). Their brains are vulnerable to the effects of alcohol. Method: There were 123 third and fourth year college students, 19–23 years old, who completed the Self-Rating Effects of Alcohol (SREA), Modified Timeline Follow-back (TFLB), Brief Young Adult Alcohol Consequences Scale (BYAACS), and Alcohol Effects Questionnaire (AEQ) once per month on a secure online database, as reported elsewhere (Dager et al., 2013). Data from the 6 months immediately before memory testing were averaged. In a single testing session participants were administered the Mini International Neuropsychiatric Interview–Diagnostic and Statistical Manual for Mental Disorders-Fourth Edition-Text Revision (MINI-DSM–IV–TR), measures of PM (event-based and time-based), and retrospective memory (RM). Based on the average score of six consecutive monthly responses to the SREA, TLFB, and AEQ, students were classified as nondrinkers, light drinkers, or heavy drinkers (as defined previously; Dager et al., 2013). Alcohol-induced amnesia (blackout) was measured with the BYAACS. Results: We found a relationship between these alcohol use classifications and time-based PM, such that participants who were classified as heavier drinkers were more likely to forget to perform the time-based PM task. We also found that self-reported alcohol-induced amnesia (blackouts) during the month immediately preceding memory testing was associated with lower performance on the event-based PM task. Participants’ ability to recall the RM tasks suggested the PM items were successfully encoded even when they were not carried out, and we observed no relationship between alcohol use and RM performance. Conclusion: Heavy alcohol use in college students may be related to impairments in PM. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Evaluation of relational reasoning by a transitive inference task in attention-deficit/hyperactivity disorder.


Objective: Here we explored whether children with ADHD have a deficit in relational reasoning, a skill subtending the acquisition of many cognitive abilities and social rules. Method: We analyzed the performance of a group of children with ADHD during a transitive inference task, a task requiring first to learn the reciprocal relationship between adjacent items of a rank ordered series (e.g., A>B; B>C; C>D; D>E; E>F), and second, to deduct the relationship between novel pairs of items never matched during the learning (e.g., B>D; C>E). Results: As a main result, we observed that children with ADHD were impaired in performing inferential reasoning problems. The deficit in relational reasoning was found to be related to the difficulty in managing a unified representation of ordered items. Conclusion: The present finding documented a novel deficit in ADHD, contributing to improving the understanding of the disorder. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

The effect of positive symptoms on social cognition in first-episode schizophrenia is modified by the presence of negative symptoms.


Objective: There is considerable evidence that patients with schizophrenia have neurocognitive and social–cognitive deficits. It is unclear how such deficits in first-episode schizophrenia relate to current clinical symptoms. Method: Fifty-nine patients with first-episode schizophrenia (FES) were tested using the Danish version of NART (premorbid IQ), subtests from WAIS-III (current IQ), and global cognition using Brief Assessment of Cognition in Schizophrena (BACS), a neurocognitive test battery. Social perception was tested using film clips of everyday interactions (TASIT). Theory of mind (ToM) was tested using silent animations (Animated Triangles Task). The FES subjects had been experiencing psychotic symptoms for several years (mean duration 9.5 years 95% confidence interval (CI [7.6;11.3]). The FES patients were divided into clinical subgroups based on their level of positive and negative symptoms (using SANS and SAPS). Healthy controls were matched to the patients. Results: High levels of negative symptoms were associated with low estimated functional IQ and poor neurocognition and social cognition. All SANS subscales, but Avolition-Apathy, had significant negative impact on social cognition. The effects of positive symptoms were complex. High levels of delusions were associated with higher premorbid IQ. In the presence of high levels of negative symptoms, high levels of positive symptoms were associated with the most comprehensive deficits in social perception, while, in the absence of negative symptoms, high levels of positive symptoms were not associated with such deficits. Conclusion: The results suggest that social–cognitive training will need to take account of the above mentioned effects of symptoms. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)

Leveraging the test effect to improve maintenance of the gains achieved through cognitive rehabilitation.


Objective: An important aspect of the rehabilitation of cognitive and linguistic function subsequent to brain injury is the maintenance of learning beyond the time of initial treatment. Such maintenance is often not satisfactorily achieved. Additional practice, or overtraining, may play a key role in long-term maintenance. In particular, the literature on learning in cognitively intact persons has suggested that it is testing, and not studying, that contributes to maintenance of learning. The present study investigates the hypothesis that continuing to test relearned words in persons with anomia will lead to significantly greater maintenance compared with continuing to study relearned words. Method: The current study combines overtraining with the variable of test versus study in examining the effects of overtesting and overstudying on maintenance of word finding in 3 persons with aphasia. First, treatment successfully reestablished the connections between known items and their names. Once the connections were reestablished (i.e., items could be named successfully), each item was placed into 1 of 4 overtraining conditions: test and study, only test, only study, or no longer test or study. Maintenance was probed at 1 month and 4 months following the end of overtraining. Results: The results are consistent with an advantage of testing compared with studying. All 3 participants showed significantly greater maintenance for words that were overtested than for words that were overstudied. This testing benefit persisted at 1 month and 4 months after completion of the treatment. In fact, there was no clear evidence for any benefit of overstudying. Conclusions: The present study demonstrates that overtesting, but not overstudying, leads to lasting maintenance of language rehabilitation gains in patients with anomia. The implications for the design of other treatment protocols are immense. (PsycINFO Database Record (c) 2017 APA, all rights reserved)(image)